Achieving Bipartisan Support for Health Care Reform – The Club 20 Approach


There was a time when reforming the health care system had bipartisan support, at least, in Colorado.


The focus on cooperation rather than opposition had its genesis in the efforts of Club 20- a bipartisan, public-private organization formed in the 1950s to serve as an advocate for the interest ofWestern Colorado.


For its first fifty years, Club 20 focused on water, transportation, agriculture, energy, tourism and other drivers of economic development for the Western Slope.  Ten years ago, Club 20 added health care to its agenda.


The Club 20 focus on health care started modestly.


They recognized that the delivery system in ruralColoradowas very different from that found in the State’s metropolitan areas.  Therefore, it needed a unique approach to addressing its health care needs and challenges.


Club 20 tasked a Steamboat Springs nurse, aDurangohospital board member, and aGrand Junctionlawyer with spearheading the effort to persuade policy makers to consider rural issues.


They focused on three areas- affordability, quality medical care and access for everyone.  Following these principles, Club 20 crafted a proposal that has many of the elements of the current national health care reform act but did so in a way that created consensus and not division.


The proposal envisioned the current Colorado Health Benefit Exchange.  It would be a virtual marketplace for consumers and small employers to compare actuarially equivalent health plans offered by different insurance companies – a chance to compare “apples to apples”.  It would also offer premium subsidies for many families (those making up to $88,000 a year) who needed financial help to purchase insurance.


Club 20 focused on pro-market, common sense ways to ensure access to care using a health plan that fits the needs of each consumer.


This concept served as the basis for the proposal authored by the 208 Commission, a bipartisan health care reform commission inColorado. The governor and the legislature adopted many elements of the 208 Commission’s proposal.


A number of health care experts across the country have taken notice of the success achieved on the Western Slope in delivering, affordable, quality health care that is available to everyone in the community.  As a result, Western Coloradohas become a model for other communities.  Both Elinor Ostrom, a Nobel Prize recipient in Economics, and Harvard surgeon (and New Yorker writer) Atul Gawande have pointed to the Western Slope’s success.


When theDartmouthMedicalSchoolevaluated the most efficient health systems in the country,Western Coloradocame out on top.


This begs the question, what can we learn from Club 20’s efforts and accomplishments on the Western Slope?


When Club 20 formed its health care task force, it made sure it included individuals with diverse backgrounds.  The group also decided to get input from all parts of the health care and political spectrum.


The task force was chaired by a family practice physician and featured leadership roles for small businesses, consumers, single-payer advocates, and the insurance industry.  They debated and discussed issue after issue, challenging each other’s assumptions and forging compromises to achieve consensus.


Maybe most importantly, Club 20 recognized tough issues are best addressed in an open, public forum where the focus is on what is best for the community as a whole.


In the words of Dr. Ostrom:  “Maybe we can solve health care by seeing how communities solve their other problems.”  Small wonder Dr. Ostrom’s team considered cities throughout the country, and decided to begin their effort by looking atWestern Colorado.


The respect for the expertise and success of Club 20 andWestern Coloradocontinues to grow.  Compare the 208 Commission of 6 years ago – where the Western Slope was represented by 1 of the 24 members– to the current Board of Directors for the Colorado Exchange.  Fully one-fourth of the members of the Exchange Board reside inWestern Colorado, including two of the three original leaders of Club 20’s health care committee (the third is now a state senator on the Legislative Review Committee for the Exchange).  Just as significantly, one-third of chairs of the Exchange Board’s work groups hail from the Western Slope, and include one of the co-authors of Club 20s original proposal.


Club 20 continues its efforts to make the health care system better.  On July 18th, the Health Care Committee of Club 20 will convene in Telluride to debate the individual mandate and its role in attaining affordable health insurance.  We will be live tweeting at the event @rmhp.


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